Provider Demographics
NPI:1235016486
Name:TRICITY PAIN ASSOCIATES PA
Entity type:Organization
Organization Name:TRICITY PAIN ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EFIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-536-3119
Mailing Address - Street 1:PO BOX 642016
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75264-2016
Mailing Address - Country:US
Mailing Address - Phone:210-756-5989
Mailing Address - Fax:210-568-4064
Practice Address - Street 1:18707 HARDY OAK BLVD STE 230
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4890
Practice Address - Country:US
Practice Address - Phone:844-789-7246
Practice Address - Fax:888-880-9323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty